Naureen Aqueel

Archive for the ‘University publications’ Category

Published in The Ward, Nov 27, 2012.


Another osteoporosis drug has been linked to unusual thigh bone fractures in a small number of users, according to an alert issued by Health Canada.

Amgen Canada, the company that produces the drug denosumab under the brand name Prolia, joined with Health Canada in issuing a warning statement last week. Amgen said, however, that instances of the fractures were very rare.

Last year, a warning was issued by Health Canada about an entire class of osteoporosis drugs, known as bisphosphonates, which had been linked to unusual thigh bone fractures in users.

These unusual fractures, which are known as Atypical Femoral Fractures (AFF), can occur with little or no physical impact. They have often been associated with long-term use of certain osteoporosis medications. The fracture is often preceded by thigh or groin pain which may occur several weeks or months before the actual fracture.

“This is new safety information related to unusual thigh bone fractures and the use of Prolia,” Sabrina Paiva, senior manager for product communications at Amgen, told The Ward.

“Cases of AFF have been confirmed in patients receiving Prolia participating in the ongoing open-label extension study of the pivotal phase three fracture trial in postmenopausal osteoporosis,” said Paiva. “These events have occurred very rarely in less than one in every 10,000.”

Health Canada said the study is evaluating the long-term efficacy and safety of Prolia in 4,550 post-menopausal women.

The drug Prolia is used in the treatment of post-menopausal women with osteoporosis who have been found to be at high-risk for fracture. It works by reducing the amount of bone broken down by the body, making bones less likely to break.

Osteoporosis Canada, the national organization working for people who have or are at risk of osteoporosis, said in a statement released last week that while unusual fractures had been seen in people taking bisphosphonates and denosumab for several years, a causal relationship between the use of osteoporosis medications and these fractures had not yet been confirmed. The statement also said that the atypical fractures had been reported without osteoporosis therapy.

Tanya Long, education manager at Osteoporosis Canada, stressed although there has been some instances of these fractures associated with the use of denosumab, “they were very, very rare.”

Blossom Leung from Health Canada’s communications office said that all marketed health products have benefits and risks associated with their use.

“Health Canada continues to monitor the safety profile of health products once they are marketed to ensure that the benefits of the product continue to outweigh the risks,” said Leung in an e-mail to The Ward.

Leung said manufacturers  are also responsible for the continuous assessment of the benefits and risks of their health products.  “The risks of a health product should never be considered in isolation, but instead, the balance between possible risks and potential benefits needs to be taken into account, with benefits always outweighing the risks,” she said.

Leung added that information on adverse reactions, precautions, warnings and contra-indications associated with health products is provided in the product information to keep prescribers and patients informed.

Osteoporosis Canada recommends patients who are taking osteoporosis medications and experiencing symptoms like pain in the thigh or groin to contact their doctors immediately.

Published in The Ward, Nov 27, 2012. 

New federal regulations that aim to give more health-care providers the authority to prescribe narcotics and other controlled substances will not immediately take effect in Ontario because of a provincial law that prohibits this practice.

The federal government announced new regulations last week that allow nurse practitioners, podiatrists and midwives to prescribe certain medications classified as controlled substances, including morphine, codeine, fentanyl and diazepam.

The move is aimed at improving health care service delivery, said Jocelyn Kula, manager of the regulatory policy division for Health Canada’s Office of Controlled Substances.

Health Canada published the regulation covering a “new classes of practitioners” on Nov. 21.

“What they broadly do is to remove any federal impediments to certain classes of health professionals being able to prescribe controlled substances,” Kula said. “But the catch is that in order for one of the classes of health professionals to be able to use their new authority, they need to have the similar authority provided to them at the provincial or territorial level.”

Kula said the new regulations should allow patients to get care and access to drugs in a more timely manner. People will no longer have to go to multiple health-care professionals or jump through various hoops before getting required care or drugs.

Midwives in provinces that allow them to prescribe the listed drugs will also be allowed to provide access to medication for women who choose to have a home birth. They wouldn’t have to wind up in hospital just to access drugs needed to ease labour, Kula said.

Kula said the new regulations came into effect after a series of requests and exchanges from certain provinces and professional health associations, which informed Health Canada that the limits in prescribing authority were disrupting the delivery of health services.

The College of Nurses of Ontario issued a notice to nurse practitioners in the province after Health Canada published the new regulations, alerting the health-care providers that it was still illegal for them to prescribe any controlled substances, including narcotics, under the provincial Nursing Act.

Bill Clarke, a college spokesman, said in an email that all the federal changes have done is to give each province the power to make its own decisions around the prescribing authority of practitioners.

“Now, however, with this change in federal law, the College of Nurses of Ontario has the power to propose changes to the Ontario Ministry of Health around nurse practitioners prescribing of these drugs,” Clarke said.

“The college will work with Ontario’s nurses and stakeholders to develop provincial regulations around this aspect of nurse practitioners’ practice in a manner that supports the public interest and builds confidence in nursing regulation.”

No one was available for comment from the provincial health ministry.

The Canadian Nurses Association called the new regulations a “milestone for nurse practitioners and the patients they care for.”

Nurse practitioners – who are experienced registered nurses with advanced training and education that allows them to make certain medical diagnoses, write some prescriptions and administer some treatments – have often been called vital links that help make the health-care system more efficient.

Although a majority of them work in community health centres and family health teams, they can also be found in emergency departments and long-term care institutions. In the past, moves to expand the powers of nurse practitioners have been hailed as key to preventing overcrowding and speeding the delivery of care.

Last month, British Columbia approved regulation to allow nurse practitioners to admit and discharge patients, becoming the second jurisdiction in Canada, along with Ontario, to allow those powers.

While many in the medical community have welcomed the new regulations, not everyone is excited about this decision. Joanna Binch, a nurse practitioner at the Somerset West Community Health Centre in Ottawa, said that while she has been in situations where she could have prescribed something to a patient, she was happy to have not had the authority to do so, particularly when prescribing narcotics.

“The situation that I run into much more often is that people are requesting narcotics,” Binch said.

“And I often like not being able to prescribe them because I can say, ‘Look, I know you have an addiction or you would like this, but this is not something I can deal with. Let me talk about anything else you would want to talk about.’ And it just changes the priority of the visit. But as I say, I’m sure this is not the case for many nurse practitioners who are in different settings.”

Published in The Ward, Nov 20, 2012. 

2012-11-20 11.47.27

Ottawa has 22 neighbourhoods that have inequitable access to healthy foods, Dr. Elizabeth Kristjansson of the award-winning Ottawa Neighbourhood Study said Tuesday at an event organized by Ottawa Public Health. Kristjansson who was speaking at the Meet, Eat and Learn (M.E.A.L) forum at the Ottawa Public Library said that neighbourhood design and community access to grocery stores can cause a number of potential health issues.

Kristjansson spoke of a consistent link that has been found between poor health and poor access to healthy foods in areas that do not have grocery stores nearby.

“People that live in these areas with poor access to grocery stores are consistently found to have poorer diet, high rates of obesity, higher rates of diabetes and higher rates of cardiovascular diseases,” Kristjansson said.

But Kristjansson pointed out that these were not necessarily true causal relationships. Studies have only revealed a consistent link between poor health and poor access to healthy food, she said.

“Food purchasing patterns have been found to be not only related to price but convenience,” she said. “People shop at the closest places.”

The head of the Ottawa Neighbourhood Study, who is also an associate professor at the University of Ottawa, said that areas that have a “food imbalance,” which she described as a higher ratio of unhealthy things like convenience stores and fast food restaurants to grocery stores, have higher mortality rates. She said the issue posed a complex problem for urban and health planning policy makers.

Kristjansson announced the launch of the Ottawa Neighbourhood Study website that presents food-related data and information on the strengths and challenges for each neighbourhood. Her team won the national prize for collaborative research – a $25,000 award from the Canadian Institutes of Health Research – in September.

The study, which was launched in 2005, brings together the work of contributors from the University of Ottawa, Ottawa Public Health, the City of Ottawa, local community health and resource centres, Carleton University, United Way/Centraide Ottawa, IBM, The Champlain Group and the Ottawa Food Bank.

The study maps and profiles more than 90 neighbourhoods and lists demographics, incomes and other social determinants for them.

“The Ottawa Neighbourhood Study has a great impact on informing public policy and has contributed greatly to better public education at the community level,” Kristjansson said in an earlier statement.

The study identified “food deserts” in various parts of Ottawa where residents have to walk great distances to find a grocery store. Kristjansson said that the findings showed that a lot of the food deserts were concentrated in the downtown area, but that not all lower income areas in the city’s centre face that problem. “A lot of downtown lower-income communities have great access,” she said.

Some other neighbourhoods of concern identified in the study were Bayshore, Greenboro and Carlington.

Other Canadian cities are now considering starting their own versions of the neighbourhood study.

Dr. Isra Levy, a medical officer at Ottawa Public Health, said the data was vital for public policy. “With this new data in hand, Ottawa Public Health and our partners can better address social challenges such as the lack of proper access to healthy food,” Levy said in a statement.

Other organizations working on food insecurity in the city also participated and spoke at the event. Just Food, Ottawa Food Bank, Poverty and Hunger Working Group and the School Breakfast program were some of the organizations that presented updates about their work.

Jamie Hurst, a nutritionist at Ottawa Public Health who was one of the organizers of the event, said the event was a contribution by the organization towards dealing with food insecurity.

“We recognize that food and security, and specifically hungers, are significant issues in our city,” Hurst said. “At the same time we recognize that we cannot solve the problem on our own. It requires a collaborative effort among many, many partners and so we wanted to have the opportunity to bring all of those partners together.”

Published in The Ward, Nov 20, 2012.

Photo credit: Ottawa Innner City Health

Photo credit: Ottawa Innner City Health

Community health centres and organizations for the homeless in Ottawa are lobbying the Ontario government to reverse a decision to eliminate benefits that help vulnerable people pay a portion of their housing-related costs.

Eliminating the Community Start-Up and Maintenance Benefit (CSUMB) will have “inequitable and unavoidable” health impacts on already vulnerable populations, argues a recently released report by the Wellesley Institute, a Toronto-based research and health policy organization.

Community health centres across the province maintain that the housing benefit, which is scheduled to be terminated on Jan. 1, helps people receiving social assistance to pay onerous and unexpected accommodation costs and, ultimately, to obtain or maintain a home.

Lindsay Snow, a community engagement worker at Centretown Community Health Centre on Cooper Street in downtown Ottawa, said the bid to reverse the province’s decision to end the benefit would put a strain on community health centres in the city.

“It would make more of our clients stay homeless longer,” said Snow. “There is a correlation between being homeless and health. It impacts negatively on your mental as well as physical health. And our already busy homeless programs will certainly become busier.”

The Wellesley Institute published a health-equity impact assessment report last week that shows the government’s decision to cut the funding could result in people on social assistance becoming homeless with negative health consequences. The assessment was conducted with health care centres as well as income security and housing organizations.

Steve Barnes, a policy analyst at the Wellesley Institute and a contributor to the report, said during an interview that all the organizations that participated in the study agreed the cut was going to have significant impacts on health and social outcomes for those who have relied on the benefit in the past.

“The problem with all these things is that once people can’t pay their housing-related expenses, they often end up either homeless or they end up in substandard housing and these are things that have really negative health impacts,” said Barnes. “So the argument that we are making is that by cutting this relatively inexpensive benefit, you are going to end up with a sicker population and then we will just end up paying for it through the health care system and other things.”

The benefit, which provides $799 to a single person and $1,500 for families, has been in place for the last 20 years. It provides low-income earners access once every two years to money to cover costs of first and last month’s rent, outstanding utility bills, and essential household items. More than 1,600 people rely on the benefit each month in Ontario.

The province is only passing half of the funding recovered from the cut on to municipalities as part of a consolidation of housing programs. Municipalities have been struggling to fill the funding gap.

Last week, city councillors voted to take $250,000 extra from Ottawa’s daycare budget to put to the social services budget, seeking to offset a $7-million provincial cut. The move was termed a one-time solution by councillors and community members, who said it would not be sustainable in the long-term.

Municipalities are not expected to have homeless prevention plans in place until 2014 – a full year after taking responsibility for the new program.

“Municipalities haven’t had to deal with these programs, so they are going to first have to work out how they are running these programs, and then each municipality is coming up with different decisions,” said Barnes.

“One of the problems is that you might end up having a completely different response in Ottawa than you would have in Toronto, or in Hamilton or anywhere else in the province. We are creating these really inequitable situations across the province where it could be worse to be homeless in Ottawa than it could be in Toronto, for example.”

Barnes said the earlier practice of dealing with these problems provincially helped create consistency in the response across Ontario.

The provincial government maintains the move to eliminate the benefit is an attempt to combine housing and homelessness support programs. Half of the provincial CSUMB funding will mean $62.6 million goes to support the new consolidated program and will give municipalities more flexibility to address their local needs, says the Ministry of Community and Social Services website.

Wendy Muckle, executive director of Ottawa Inner City Health — which provides health care services to the homeless — called the provincial government’s decision to eliminate the housing benefit “fairly short-sighted.”

Muckle said she could not understand why the government was picking to eliminate this benefit. “It is not a huge amount of money but it will affect a lot of people very negatively,” she said. “Clearly when you are picking what things need to go, you try to pick things that have the least amount of impact on the least amount of people, and I think there is general consensus that this doesn’t meet those criteria.”

“Being homeless is not good for your health and the longer people remain homeless the greater impact it has on their health,” said Muckle. “Unfortunately, things like this that don’t necessarily seem like a huge change of policy often have a tremendous long-term impact on both the amount of people that are sick and what their life expectancy is.”

The report released by the Wellesley Institute recommends the province reinstate the CSUMB or at least delay it until 2014 so that municipalities have more time to ensure they can meet local housing needs. This would also give the government time to carry out a health equity impact assessment to determine the potential effects of its decision.

Published in The Ward, Nov 6, 2012.

Students at Carleton University are pushing for a fall break to reduce stress levels, but counselling services at the University of Ottawa — which already has a fall reading week — say there’s little evidence the break helps students manage stress.

Donald Martin, manager of counselling and coaching services at U of O, said that since the fall reading week was implemented last year, he hasn’t seen any evidence that students are less stressed.

“I would say that there are probably more students coming to us since (the break),” Martin said. U of O had proposed the reading week in 2009 but its inaugural year was 2011.

In fact, Martin said the break seems to increase stress levels for students later in the term.

“In some cases, it probably increases their stress,” he said. “When they have a week off, they make themselves all sorts of promises to study hard and catch up and all that. Most of them end up spending two or three or four days doing nothing and then they feel guilty about all the things they thought they were going to do and didn’t do.”

Martin said the introduction of the break came at the cost of a tighter exam schedule.

“It makes certainly for a bit more stressful exam period. Because of the extra time off, my understanding is that they shorten the exam period and exams tend to be scheduled closer to each other. So that makes for probably more stress in December.”

November is a busy month for student counselling services, Martin said.

“Last November we had an increase of about 30 per cent in terms of total requests compared to the November of the year before.”

In 2010, the U of O counselling services saw 210 counselling requests from students and in 2011, the requests had risen to 250.

“The main concern in November is that students are feeling overwhelmed with school oftentimes and at other times with life,” Martin said.

Martin added that in November, his office usually sees students who aren’t happy with the mid-term results they have received, and at other times students come in because they are overwhelmed by their workload. And as a crisis intervention centre, requests may relate to a student’s personal or family life, not just school, Martin said.

The Carleton University Students Association and the Carleton Academic Student Government recently presented to the Senate results of a student poll. Carleton students were asked their opinion on the inclusion of a fall break in the academic calendar to occur from Thanksgiving Monday on Oct. 14 to the Friday.

The poll found that about 5,600 students, close to 70 per cent of those who voted, voted in favour of a fall break.

The Graduate Student Association also favours a fall break, but suggested later dates.

Kelly Black, president of the Graduate Student Association, said the organization is asking for the break to be scheduled for the end of October — at the same as the U of O. Black said the association has expressed its concerns about the timing to the Senate and are waiting for them to take a decision.

“One, it would make a lot of sense to have the same schedule as the University of Ottawa so that courses would sync up because many students at Carleton and the U of O take courses at both institutions,” Black said.

Black also cited student mental health concerns.

“It makes sense to have it sort of at the height of all that (stress), closer towards the middle of the term rather than closer to the beginning,” Black said. “If we have a break at the end of October, hopefully it will give students a much-needed break from assignments and give them time to catch up on assignments and time to spend with friends and family.”

Martin said that although being a student is a stressful activity, his experience has been that students are generally a “resilient bunch.”

“I don’t think that students are necessarily, more or less than other groups of the population, affected by mental health problems,” Martin said. “I think that mental health issues happen everywhere. It is just that when you bring students in a certain context where they have to produce a lot of work, study hard and if they have associated pressures, sometimes it can create situations where they are overwhelmed.”

Published in The Ward, Nov 6, 2012.

Photo credit: Creative Commons

Photo credit: Creative Commons

Winters, closed windows and doors and a tasteless and odourless radioactive gas – this deadly combination is what Health Canada is raising awareness about this November as part of its campaign for lung cancer awareness month.

Recent research by Health Canada shows that exposure to radon gas, a naturally occurring radioactive gas, is the second leading cause of lung cancer in Canada after tobacco smoking. The study found that 16 per cent of lung cancers were induced by radon exposure inside the home, said Kelley Bush, head of radon education and awareness at Health Canada. The organization is encouraging Canadians to test radon levels in their homes.

Bush said a cross-Canada survey of 14,000 homes conducted by the organization in 2011 also shows that about seven per cent of homes have high levels of radon.

“The research also validated our recommendations to Canadians for an all-Canadian home ownership test, because really at the end of the day, that is the only way to know,” said Bush.

“We can’t tell you because you live in this certain area, you have this type of house that you are going to have high levels of radon or you are not. So, that is why Health Canada recommends that all homeowners have to test their radon. And our recommendation is that you should do that using a long term test for a minimum of three months, ideally in the fall-winter time frame.”

The type of radiation released by radon, known as alpha radiation, poses no risk to the outside body as it cannot penetrate the skin, Bush said. The risk is to the lung tissue which has no protection. “What happens is you breathe the radon in, it lodges in a lung tissue and the type of radiation that it is, it stays around for almost four days,” said Bush. “Alpha radiation releases energy and when that energy is released into the lung tissue, it can effect the cells and the DNA in those cells which overtime can lead to lung cancer.”

But the risk of lung cancer is not immediate, said Bush. “Someone does not all of a sudden, in one day, get lung cancer. Typically, it is years, decades of exposure.”

Radon is a radioactive gas that is produced naturally by the decay of uranium, found in soil, rock or water. It is invisible, tasteless and odourless and can move freely through the soil and enter buildings undetected through cracks in the floors or gaps around pipes. Confined to enclosed or poorly ventilated spaces, it can accumulate to high levels. Radon levels are generally highest in basements and lower levels of homes. When radon escapes into the outdoor air it gets diluted, and the levels are negligible and do not pose a health risk.

“Everyone has radon present in their homes,” said Bush. “It is not a question of whether or not you do have radon. It is everywhere. It is in every home. The question is how much. Because the health risk associated is dependent on how high the level is and how long you are exposed for.”

The Lung Association of Canada is also working with Health Canada to raise awareness about radon exposure in homes. Both organizations are encouraging Canadians to test radon levels in their homes. Homeowners have two options: they can hire a certified professional who can carry out the test for them or they can purchase a do-it-yourself test kit and test radon levels themselves.

Janis Hass, a spokesperson of the Lung Association said the test can be purchased all across Canada, either through provincial lung association units or at any home improvement store.

“Testing is really easy,” said Hass. “We recommend the long term radon test, because they are more accurate than the short term ones.”
The test requires putting the detector in the basement and leaving it there for three months. After this period, the detector is sent back to a lab which sends the results back to the homeowner. Health Canada recommends testing levels up to the second floor.

The Canadian guideline released by Health Canada recommends remedial measures to be undertaken in a dwelling whenever the average annual radon concentration exceeds 200 becquerels per cubic metre in the normal occupancy area. Becquerel is the unit used by scientists to measure the number of radioactive decays of radon atoms. The guideline says the higher the radon concentration, the sooner remedial measures should be undertaken and that when remedial action is taken, the radon levels should be reduced to a value as low as is practicable.

Hass said the Lung Cancer Association has been raising awareness about radon exposure for the past three years. “It has always been a problem that has existed but people weren’t aware of it,” said Hass. “So we were working with Health Canada to make more people aware because the concentration of radon effects more homes than people had previously thought it does.”

If high levels of radon are found in a house, there are methods like sub-slab-depressurization, sealing of entry points and increased ventilation that are recommended to lower the levels. Specialized mitigators can also be hired to help deal with high radon levels.

A cross-national analysis of 108 non-news articles from nine newspapers across the world


Extremism, fundamentalism, terrorism and other related terms are at the heart of global media discourse since the past few years. The press has been fundamental in shaping our attitudes and perceptions regarding these issues by effectively defining and redefining these concepts for us. This research attempts to explore how the global press is defining and framing extremism and its variants by using a quantitative and qualitative analysis of texts of 108 non-news articles picked up from nine newspapers across the world. Findings revealed that a variety of loaded terminologies were being used to define extremism and its opposing concepts and that media definitions were often influenced by dominant political discourse. Extremism was found to be talked about majority of the time in relation to Islam and Muslims. A growing trend of associating extremism to religious adherence, symbols and education was also found. Western newspapers from the U.S. and U.K were often found to associate extremism to being anti-West and moderation to being pro-West and had among the highest instances of association of extremism to Islam.


The media play a fundamental role in educating audiences about various social realities. The question of how the media mediate between the external objective reality and our perception of social reality has been one of the major themes of Mass Communication research. There has been particular interest in the ‘reality definition’ function of the press. The press has been instrumental in educating readers, creating awareness about issues, defining our perceptions of reality and changing attitudes.

The role of language in reporting and discussing particular topics is also one of importance in media studies. How the use of terminologies and language in the media is in accordance with dominant political discourse in society and how this subsequently shapes media portrayals and definitions is another important aspect of this debate.

Of late, there has been a lot of focus on topics like extremism, moderation and terrorism in the media. The press has been at the centre of shaping our perceptions and attitudes regarding these issues. The media not only report incidents of terrorism and militancy, they have also come to define these concepts for us.

The purpose of this research is to examine how the global press is defining extremism and its various linguistic variations. The sample comprised a collection of 108 non-news articles (including columns and editorials) picked from 9 publications across different countries from different regions of the world. 12 write-ups were selected from each newspaper on the basis of a convenience sample with the criteria of selecting articles using one or more of a variety of terminologies relating to extremism.

The newspapers were selected on the basis of circulation figures as well as off-record hegemony. A further limitation that emerged in determining selection was the condition that the newspaper that was to be used had to have a website and subsequently, an online archive providing free access to the ‘Comment’ or ‘Opinion’ section of that publication for the period of time covered in the study. The comparative cross-national analysis allows for a study of differing perceptions and concept frames in different countries and different contexts. The study uses a combination of quantitative and qualitative analysis of the media texts selected in the sample.

Extremism, fundamentalism, radicalism, fanaticism, terrorism etc are elusive terms and it is difficult to attach one single meaning to them. We know that one man’s terrorist is another man’s freedom fighter and we have also seen that yesterday’s terrorists can be today’s statesmen.

While a search fails to bring up much about the origins of the term ‘extremism’, there seems to be some amount of material available on the origins of the term ‘fundamentalism’. The term ‘fundamentalism’ has been used in so many contexts that its origins have been obscured. Like other scholarly terms that have entered general usage (‘Charisma’ for example), popularity has resulted in a degradation of the meaning of the term as well as questionable applications (Weinberg and Pendahzur, 2004). The origins of the term ‘fundamentalism’ lie firmly in American Protestantism. After a lengthy debate about evolutionary biology and creation, the Protestant denominations gradually separated into ‘modernists’ who argued that believers needed to adapt to the findings of science and scholarship, and ‘traditionalists’ or anti-modernists who insisted upon maintaining the older views of revelation and biblical inerrancy. As the struggles between the two groups progressed, the views of anti-modernists were articulated in a set of pamphlets published between 1910 to 1915, under the title of ‘The Fundamentals’. Gradually, those who supported this position began to term themselves ‘fundamentalists’ (Weinberg and Pendahzur, 2004).

The absence of one agreed meaning for the aforementioned terms in current usage is readily apparent. But in the presence of such a case, these terms lend themselves to more manipulation and engineering by the dominant political and media elite of a society. In the post September 11 scenario, these terms have acquired more political connotations and are actively being defined and redefined by the media. These definitions are not always correct as the media have a tendency to be shaped by dominant political discourse. In the present day scenario, these terms have in fact become political terms to create hysteria against certain groups.

Well-known journalist, Robert Fisk, the London-based Independent’s Middle East correspondent describes this quite well when he writes:

““terrorism” no longer means terrorism. It is not a definition; it is a political contrivance. “Terrorists” are those who use violence against the side that is using the word. The only terrorists whom Israel acknowledges are those who oppose Israel. The only terrorists the United States acknowledges are those who oppose the United States or their allies. The only terrorists Palestinians acknowledge—for they too use the word—are those opposed to the Palestinians.” (Fisk, 1990)

The content of newspapers is not really facts about the world, but in a very general sense ‘ideas’ and in this, language is not neutral but a highly constructive mediator (Fowler, 1991). The language the media use can help shape opinions and perceptions and consequently influence action against certain groups in society. By repeatedly associating certain phenomena through use of language and terminology, the media are able to shape definitions of phenomena. And with the immense power and ubiquity that the media have acquired today, it becomes increasingly important to monitor how the media are defining certain terms and what stereotypes and notions they are creating.

A principle that has been long understood by propagandists is that a lie which is repeated often enough becomes widely accepted as truth (Rampton and Stauber, 2003) and that by repeated associations of two or more phenomena the desired concepts tend to acquire commonsense status in a society.

Walter Lippmann’s concept of ‘manufacturing consent’ (a term popularised by the works of Noam Chomsky) is an interesting angle that can be applied to this debate. The concept contends that in democratic societies, the less the state is able to employ violence in the interests of the elite groups that effectively dominate it, the more it becomes necessary to devise techniques of “manufacture of consent” (Chomsky, 1986).

Chomsky (1986) puts forward that one way of “manufacturing consent” is to devise an appropriate form of “Newspeak” in which crucial terms have a technical sense divorced from their ordinary meanings. The term “newspeak” was coined by George Orwell to describe words “deliberately constructed for political purposes: words, that is to say, which not only had in every case a political implication but were intended to impose a desirable mental attitude upon the person using them.”

Orwell was an ardent observer of the relationship between politics and language. In one of his collections, he wrote: “In our time, political speech and writing are largely the defense of the indefensible. Things like the continuance of British rule in India, the Russian purges and deportations, the dropping of atom bombs in Japan, can indeed be defended, but only by arguments which are too brutal for most people to face, and which do not square with the professed aims of political parties. Thus political language has to consist largely of euphemism, question-begging and sheer cloudy vagueness” (Orwell, 1970).

Chomsky (1986) uses the example of the phrase “peace process” to explain the idea of “newspeak”. According to how the term is used in the mass media and the U.S. scholarship, “peace process” means peace proposals advanced by the U.S. government in the context of the Middle East crisis. If the Palestinians, for example, refuse to accept the U.S. terms of the peace process, they are in effect described as rejecting peace in accordance with the “newspeak.” The desired conclusion follows, whatever the facts (Chomsky, 2007).

Similarly, Chomsky (2007) uses the example of another pair of “newspeak” concepts very relevant to the current study: “extremist” and “moderate”. U.S. policy is by definition “moderate” so that those who oppose it are “extremist” and “uncompromising.” The Israeli Labour coalition position then (in 1986) according to Chomsky’s description of “newspeak” was also “moderate” as it conformed to the position of the U.S.

“The terms “terrorism” and “retaliation” also have a special sense in U.S. “newspeak.” “Terrorism” refers to terrorist acts by Arabs, not Israel or the U.S.” (Chomsky, 1986). Terms like “preventing” or “reducing” violence also have another special sense in the context of Arab-Israeli conflicts. In one case for example, the Israeli and U.S media defined the attempt by villagers to run their own affairs as “violence” and a brutal attack to teach them who rules as “reducing violence.”

In his book ‘Imperial Ambitions: Conversations in the Post 9/11 World’, Noam Chomsky (2005) gives another example of an American journalist (a Middle East correspondent with tremendous experience) who writes in his article that the U.S. must be the only country in the world where someone can be called a terrorist for defending his own country from attack.

Media portrayals of concepts in many cases are influenced by the dominant cultural meanings attached to them, what in other words Orwell described as political language. People’s opinions and conceptions are often shaped by the mass media and the mass media themselves often follow dominant political discourses that support the actions of hegemonic powers. At the same time, media discourse often plays an important role is establishing and maintaining power relations in societies.

The media often have set conventional patterns of reporting and even opinion and analysis that they follow in covering events. Van Dijk (1988) calls these set patterns cognitive scripts and models of behaviour shaped by the experience and narration of previous events. These cognitive structures are shaped by dominant cultural, political and religious worldviews and the media often follow them even when covering some of the most atypical of occurrences.

The media play an important role in lending salience to various issues. We have all heard of terms like “media frenzy”, “media hype” and “moral panic”. While popular mass communication theories like Agenda-setting theory contend that while the media may not be successful most of the time in telling us what to think, they are stunningly successful in telling readers or audiences what to think about (Cohen, 1963), there are other theorists who are now arguing that media are stunningly successful in telling us not only what to think about, but how to think about it (McCombs, 2003).

We see that certain events and issues tend to become fodder for newspapers and the electronic media with reporting, commentary and analysis about them being done at unprecedented levels. In this way, the media become active participants in the course of events, shaping and creating events as they report. At many times, media involvement in the sense of reporting can have a significant effect on the event itself and even the outcome. The media therefore, are said to be actively involved in what Thompson (1995) called “constituting the social world.”

The media thus often generate news waves by lending an issue increased attention, amplifying it and creating ‘hype’ about it, subsequently influencing action regarding it. Pakistani society has often seen this sort of media generated news wave at incidences of violence in the city and those relating to threats to law and order etc.

The Pakistani media just like the global media have been giving a lot of attention to extremism, fundamentalism and terrorism. If one takes a look at any edition of any newspaper in this day and age, one will undoubtedly come across some mention or the other of extremism and terrorism. In this age of the ‘looming threat of terror’ and increased focus on the fanaticism and extremism that causes it, it is almost impossible for a day to go by with no mention of these phenomena in the media.

A Google search of Dawn’s (Pakistan’s topmost English daily newspaper) website turns up some 5400 results for ‘extremism’. A similar search for ‘fundamentalism’ turns up some 782 results on the Dawn website. Similarly, a Google search of the website of The News (Pakistan’s second most prestigious English daily) turns up 1490 results for ‘extremism’ and 203 for ‘fundamentalism’. A Google search of the American most prestigious daily, New York Times, turns up 61800 results for ‘extremism’ and 4950 for ‘fundamentalism’. A similar search done on Britain’s prestigious daily, Telegraph, turns up 3450 results for ‘extremism’ and 1790 for ‘fundamentalism.’ The amount of press coverage and mention given to these issues then is readily apparent.

What propelled the researcher to take up this topic for research was the relatively new debate in Pakistan about progressive liberalism versus religious adherence and conservatism and the tendency among the media and intellectual elites to label all signs of religion as ‘extremism’, ‘fundamentalism’ or ‘radicalism’ etc. The elite press and media of the country have relatively recently engaged themselves in this debate which tends to label all signs of religion as extremism and radicalism. This is done either directly, or indirectly, by associating religion and religious practice and conservatism with the aforementioned terms.

As an example, consider two articles that appeared in the year 2009 in one of the top monthly newsmagazines of Pakistan, Newsline: ‘The Power of the Pulpit’ and ‘The Saudisation of Pakistan’. Both these articles are representative of the popular intellectual discourse about extremism and fundamentalism that is prominent in the elite media of the country.

‘The Power of the Pulpit’, the cover story for that month, by popular journalist and novelist, Muhammad Hanif, stands critical of the growing trend of religious adherence in the society and associates it to ‘Talibanisation’, a neologism that is said to have been coined by the media to describe the increasing influence of the Taliban in the society. He calls the growing trend of religious preaching on Television as a precedent to the rise of militancy in the country. He writes:

“In Karachi, there are frequent warnings that the Taliban are headed this way. There are posters warning us about Talibanisation. Altaf Hussain thunders about them at every single opportunity. But nobody seems to warn us about the preachers who are already here: the ones wagging their fingers on TV always tend to precede the ones waving their guns, smashing those TVs and bombing poor barbers.” (Hanif, 2009, ‘The Power of the Pulpit’, Newsline)

The article, ‘The Saudisation of Pakistan’, by Pervez Hoodboy goes along the same lines, arguing that radicalism is not only a problem in FATA and that Madrassas[1] are not the only “institutions serving as jihad factories”, rather “extremism is breeding at a ferocious rate in public and private schools within Pakistan’s towns and cities”. Hoodboy associates this to the ‘Saudisation’ of the country, its educational curriculum, the building of hundreds of mosques, and the rise in the trend of women wearing the abaya[2] or burqa[3]. By linking religious practice and symbols repeatedly to the debate about rising extremism and militancy, Hoodboy like many other writers in this dominant intellectual discourse in the elite media of the country, includes these elements into the definition of the term extremism and its variations. He writes:

“While social conservatism does not necessarily lead to violent extremism, it does shorten the distance. The socially conservative are more easily convinced that Muslims are being demonised by the rest of the world. The real problem, they say, is the plight of the Palestinians, the decadent and discriminatory West, the Jews, the Christians, the Hindus, the Kashmir issue, the Bush doctrine – the list runs on. They vehemently deny that those committing terrorist acts are Muslims, and if presented with incontrovertible evidence, say it is a mere reaction to oppression.” (Hoodboy, 2009, ‘The Saudisation of Pakistan’, Newsline)

As another example, we can consider an article by popular columnist, Nadeem F. Paracha, in the most prominent daily of the country, Dawn. In his article titled ‘Nauseous mumblings’, Paracha is again critical of the trend of religious preachers on television and the growing trend of young men and women adorning beards and hijabs[4] respectively, and practising religious rituals. He calls these trends an exhibition of ‘extreme beliefs’. He writes:

“There have been recorded cases against many petty-bourgeois shop-owners and traders of financing jihadi[5] organisations; whereas many sections among the more ‘modern’ bourgeois class have largely exhibited their own version of extreme beliefs by passionately patronising (as supporters and clients), a number of Islamic televangelists and drawing-room preachers whose number has grown two-fold from 1990 onwards.

Consequently, there has been a dramatic increase in the number of young men and women from the middle-class now preferring to adorn beards and hijabs, and taking religious rituals a lot more seriously (compared to the situation till the late 1970s). But this class still constitutes a large number of westernised youth as well.” (Paracha, 2009, ‘Nauseous Mumblings’, Dawn, Images on Sunday)

This trend in the dominant intellectual discourse however is not a feature limited only to Pakistan, although it does come somewhat as a surprise that it is dominant in a majority Muslim country like Pakistan. Karim (2002) in his paper ‘Making sense of the Islamic Peril’ notes how the Northern mass media have the tendency to declare manifestations of Muslim belief such as wearing the hijab and performing the communal Muslim prayer as certain signs of “Islamic fundamentalism,” whereas the wearing of Christian religious apparel or attending church in their own countries are not usually considered signs of fanaticism. “The generalisation and polarisation of all Muslims as “fundamentalists” and “moderates,” “traditionalists” and “modernists,” “fanatics” and “secularists” serve to distort communication. They tend to make the Muslims who are interested in constructive dialogue with non-Muslims apologetic about their beliefs or, contrarily, disdainful about any interaction.”

Karim (2002) also discusses how such situations have been a recurring feature of crisis situations in the relationship between Northern and Muslim societies. He quotes Ahmed (1992) on the example of the “Rushdie Affair” when Muslims who dared criticise any aspect of Salman Rushdie’s controversial book, The Satanic Verses, risked being branded an “Islamic fundamentalist.” After the September 11 terror attack many Muslims living in Western societies were fearful of wearing traditional clothing in public, let alone engaging in discussion with others for fear of being labelled extremists or fundamentalists.

Although some Northern journalists, academics, and politicians do go against this dominant discourse and state repeatedly that Islam is not synonymous with violence or terrorism, their alternative discourses are usually overshadowed by many other opinion leaders who continue to frame information within dominant discourses (Karim, 2000). With such repeated media associations of terrorism, fundamentalism and extremism with symbols of Islamic practice like the hijab and beard, it came as no surprise then that journalists who had made much of turbans and hijabs being symbolic of “Islamic fundamentalism” were baffled that a number of people whom the Taliban had oppressed chose to continue wearing these traditional garments even after the regime was deposed (Karim, 2002).

The purpose of this research, however, is not to come up with a definition for the term extremism or other related terms. It is merely to explore how the global press is defining the term and what meanings are being associated to this concept. Although it may appear that this research is focusing only on the definitions of extremism, fundamentalism and radicalism in the context of Muslims, the research was not designed only with this aspect in mind. The plan was to examine how extremism and other related terms are being defined by the global media in the context of all religions and nationalities. However, a point worth noting—and one having other implications as well—is that most articles found discussing extremism focused on Muslims and most research literature found on the subject was also in the context of Islam and Muslims.

[1] Maddrassa, literally meaning place of study, refers to a traditional Islamic school of higher study  where the Quran and other related sciences are taught.

[2] Abaya refers to a cloak covering the body and clothes worn by Muslim women in public

[3] Burqa refers to a cloak and head-covering worn by Muslim women which often covers the face too

[4] Hijab, literally meaning veil, refers to the adherence of certain standards of modest dress by Muslim women, often referring to the head-covering

[5] Jihadi, literally meaning struggle, in popular discourse has come to refer to those who take up war for Islamic causes

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